The UK government’s women’s health strategy (2024), is an opportunity to address historical underfunding in women’s health care and research. But will it reduce systemic inequalities in women’s health? I would argue that little will change until we address the shame and stigma that are inherent to women’s health experiences.   

Shame and stigma are a recognised part of girls’ and women’s health experiences – shame about menstruation, eating disorders, gender-based violence and reproductive health conditions, such as miscarriage and infertility, as well as mental health (and importantly, perinatal mental health). Shame is conveyed in describing women’s health conditions as benign when they may be life-limiting, entailing frequent visits to general practitioners and emergency departments. 

Women face unique mental and physical health challenges, including hormonal fluctuations over the life course. Many women do not feel comfortable talking about these issues because there are few safe spaces to do so. Stress and burnout from balancing multiple social roles mean women are over diagnosed with, and medicated for, anxiety and depression. The values and attitudes a society holds about women, their bodies and their expected social roles shape the forms and level of health care that is funded and delivered.  

There are plenty of newspaper reports detailing different political regimes’ antipathy towards women and restriction of women’s health care. The Anglican and Roman Catholic churches’ attitudes to women priests is yet another example of misogynistic attitudes and gender violence towards women. This shame and stigma, which stems worldwide from the female body and women’s role as mothers, conveys a courtesy stigma to women’s health nursing – framing it as shameful. 

Nurses have always been associated with dirty work – washing and handling sick bodies, dealing with elimination and incontinence, dressing infected wounds. They are literally at risk of contamination from these tasks (from infections) and symbolically at risk from being associated with dirt, which is a social taboo even in modern societies. Their association with elimination, infection and contamination affects their status, their relationships with other health care workers and how they see themselves and their encounters with dirt. They are, in other words, stigmatised, and their work is devalued.  

Stigma in relation to women’s health arises from another source of ‘dirt’, menstrual blood, which is seen as unclean and contaminating. Ever since Florence Nightingale and Mary Seacole, nurses have blazed a trail in women’s health care. They have pioneered improvements in practice, carried out cutting-edge research and advanced education for nursing staff in the context of a largely male, patriarchal and misogynistic medical establishment. However, much can still be done by individual nurses to address stigma and by lobbying for better health care for women to reduce inequalities. 

If you’ve found the ideas in this blog worth a read, you might find the Fellows’ Conversation ‘Dirty Nursing’ – Pioneers in transforming Women’s Health’ on 6 March interesting. Fellows who are recognised for their expertise in women’s health will be on the Panel to discuss the pioneering work done in women’s health by nurses.